YOGICMANAGEMENTOF CARDIOVASCULARDISEASES

Yogacharya Dr Ananda Balayogi Bhavanani Chairman ICYER at Ananda Ashram Pondicherry, India www.icyer.com

INTRODUCTION
Cardiovascular disease is basically a lifestyle disorder. Holistic science of yoga is the best lifestyle ever designed. Modern medicine as well as yoga have sound scientificbasisandare,therefore,naturalallies. Yoga has preventive, curative as well as rehabilitativepotential. This holistic action of yoga can be explained on the basis of its ability to modulate autonomic functions, relieve stress, improve physiological functions including cardiorespiratory fitness and improve qualityoflife

Research findings
Comprehensive reviews by Innes et al (2005 & 2007) suggested that yoga reduces cardiovascular risk profile by decreasing activation of sympathoadrenal system and hypothalamicpituitaryadrenal axis and also by promoting a feeling of wellbeing along with directenhancementofparasympatheticactivity. They also suggested that yoga provides a positive source of social support that may also be one of the factorsreducingriskforcardiovasculardiseases. They reported that all 12 studies reviewed by them suggestedthatyogaimproveslipidprofile.

 Yoga lifestyle retards progression / increases regression of coronary atherosclerosis in severe coronary artery disease. It also improves symptomatic status, functional class and risk factor profile (Manchanda etal2000) A short lifestyle modification and stress management education program leads to favorable metabolic effectsandreducesriskfactorsforCVdiseaseandDM (Bijlani etal,2005). Astudyonyogicpracticesonlipid profile and body fat composition in patients of CAD reported a reduction ofTC,TGandLDLafter6months(Paletal2011).

Possiblemechanisms?
Blood pressure lowering ability of yoga training has been reported by Patel and North (1975), Datey et al (1969),Sundar (1984)andVijayalakshmietal(2004). Breathing exercises and relaxation training have beneficial effects in patients with previous myocardialinfarction(vanDixhoom1998). Shavasan and pranayama is beneficial in patients having premature ventricular complexes and palpitations(Ravindra etal,2006). Improvement of baroreflex sensitivity & attenuation of sympathetic and renin angiotensin activity followingYogatraining(Selvamurthy etal,1998). Yogaimprovesheartfriendly statusoflipidprofilein peri andpostmenopausalDM(Bhavananietal2012).

 Damodaranetal(2002)suggestedthatYogacanplay an important role in risk modification for CV diseases. Decreased BP, drug score and risk factors such as blood glucose, cholesterol and triglycerides. Overall improvement in subjective well being and quality of life with reduced sympathetic activity and oxidantstress. Pranayama breathing reduces HR and BP of hypertensivepatientswithin5mins (Bhavananietal, 2011). Yoga training blunts exerciseinduced increase in HR andBP(Madanmohan etal2004).

 A systematic review by Yang (2007) of 32 articles published between 1980 and 2007 found that yoga interventions are generally effective in reducing body weight, blood pressure, glucose level & high cholesterol Madanmohan et all (2002) reported that shavasan reduces load on the heart by blunting sympathetic response. Udupa et al (2003) reported that Pranayama training decreased basal sympathetic tone, increased basal parasympathetic activity and decreased load on the heart.

 AcomprehensivereviewbyInnes andVincent(2007) found beneficial changes in several risk indices, including glucose tolerance, insulin sensitivity, lipid profile, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation and pulmonary function, as wellasimprovementinspecificclinicaloutcomes. They suggested that yoga may improve risk profiles in adults with non insulin dependent (NIDDM) and may have promise for the prevention and management of cardiovascular complications in this population.

POSTULATEDMECHANISMSBYWHICHYOGA REDUCESCARDIOVASCULARRISK

REFERENCES
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7. Madanmohan, Bhavanani AB, Dayanidy G, Zeena Sanjay, Basavaraddi IV. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri andpostmenopausaldiabeticpatients.InternationalJYoga2012;5:1015. 8. Madanmohan, Udupa K, Bhavanani AB, Krishnamurthy N, Pal GK. Modulation of cold pressorinduced stress by shavasan in normal adult volunteers. Indian J Physiol Pharmacol. 2002;46:30712. 9. Madanmohan, Udupa K, Bhavanani AB, Shatapathy CC, Sahai A. Modulation of cardiovascular response to exercise by yoga training. Indian J Physiol Pharmacol. 2004;48:4615. 10. Manchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R. Retardation of coronary atherosclerosis with yoga lifestyle intervention.JAssocPhysiciansIndia2000;48:68794 11. Pal A, Srivastava N, Tiwari S et al. Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease. Complementary Therapies in Medicine2011;19:122127. 12. Patel C, North WR. Randomised controlled trial of yoga and biofeedback in managementofhypertension.Lancet1975;2:935.

13. Ravindra PN, Madanmohan, Pavithran P. Effect of pranayam (yoga breathing) and shavasan (relaxation training) on the frequency of benign ventricular ectopics in twopatientswithpalpitations.Int JCardiol.200622;108:1245. 14. Selvamurthy W,Sridharan K,RayUSetal.Anewphysiologicalapproachtocontrol essentialhypertension.IndianJPhysiolPharmacol1998;42:205213. 15. Sundar S, Agrawal SK, Singh VP et al. Role of yoga in management of essential hypertension.Acta Cardiol 1984;39:20308. 16. Udupa K, Madanmohan, Bhavanani AB et al. Effect of pranayam training on cardiac function in normal young volunteers. Indian J Physiol Pharmacol 2003; 47: 2733. 17. van Dixhoorn J Cardiorespiratory effects of breathing and relaxation instruction in myocardialinfarctionpatients.Biol Psychol 1998;49:12335. 18. Vijayalakshmi P, Madanmohan, Bhavanani AB et al. Modulation of stress induced by isometric handgrip test in hypertensive patients following yogic relaxation training.IndianJPhysiolPharmacol2004;48:5964. 19. YangK.AReviewofyogaprogramsforfourleadingriskfactorsofchronicdiseases. Evid BasedComplementAlternat Med2007;4:48791.